# Endoscopic Palliative Treatment for Duodenal and Biliary Obstruction in Advanced Periampullary Malignancy

## TL;DR

This case report shows how endoscopic treatments can help manage duodenal and biliary blockages in advanced cancer patients, improving their quality of life.

## Contribution

The report highlights the successful use of endoscopic techniques for palliating complex obstructions in advanced periampullary malignancy.

## Key findings

- Endoscopic retrograde cholangiopancreatography was attempted but abandoned for biliary drainage.
- Percutaneous transhepatic biliary drainage and duodenal stenting were used to relieve obstructions.
- The patient experienced significant symptom relief and improved quality of life after the procedures.

## Abstract

Unresectable periampullary malignancies can lead to concomitant duodenal and biliary obstructions, significantly affecting patient quality of life. Effective palliation of these obstructions is crucial for symptom management and improving patient outcomes. Endoscopic techniques provide a minimally invasive approach to address these complications. This report presents a case where endoscopy was successfully used to palliate both duodenal and biliary obstructions in a patient with advanced periampullary malignancy. Endoscopic retrograde cholangiopancreatography was attempted to relieve the biliary obstruction caused by periampullary malignancy; however, the procedure was subsequently abandoned and the patient ultimately underwent percutaneous transhepatic biliary drainage. Furthermore, the use of an endoscope for duodenal stenting to restore gastrointestinal continuity was done. The patient experienced significant symptomatic relief and improved quality of life post-procedure. This case underscores the utility of endoscopic interventions in managing complex obstructions due to advanced malignancies.